Provider Demographics
NPI:1073288742
Name:GRACIAL TRANSPORTATION SERVICES, LLC
Entity Type:Organization
Organization Name:GRACIAL TRANSPORTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DRICIRU
Authorized Official - Middle Name:NANCY
Authorized Official - Last Name:NOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-340-8609
Mailing Address - Street 1:12402 ASHLING DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-1207
Mailing Address - Country:US
Mailing Address - Phone:713-340-8609
Mailing Address - Fax:
Practice Address - Street 1:12402 ASHLING DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-1207
Practice Address - Country:US
Practice Address - Phone:713-340-8609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-13
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)